Infection Control
what is the difference between medical asepsis and surgical asepsis
Medical reduces micro-organisms, sterile completely removes them
Describe two important things you must do when providing oral care to an unconscious person
put them on their side and have suction near by
Name the normal ranges for vitals
temp- 96.8-100.4
respirations-12-20
pulse- 60-100
BP- systolic less than 120 and diastolic less than 80
oxygen-95-100%
A patient is on I/O. They drink a 6oz coffee, 12 oz water and 10 oz juice. What should the nurse record for fluid intake?
840 mL
What is the orthopneic position and what it is good for
client sits up with table to bend over, good for clients having trouble breathing
Name the different types of precautions and their PPE
Contact- gloves and gown
Droplet- masks, gown, gloves, goggles
Airborne-N95, gown, gloves, goggles
A patient with these diseases should have the following precautions during foot care:
-file instead of cut
-do not soak feet
-do not apply lotion between toes
diabetes and peripheral vascular disease
What are factors that can influence a temperature reading
age, hormones, exercise, dehydration, illness, food and fluid intake, smoking, stress, circadian rhythm and environment
What is the difference between a clear liquid and full liquid diet?
Full liquid also includes dairy products and all juices. Some facilities include pureed vegetables in a full liquid diet
Name the range of motion exercises
ankle pumps, foot circles and knee flexion
Name all of the situations where hand hygiene is called for
Before and after patient contact
-After removing gloves
-When hands are visibly soiled
-After contact with bodily fluids
-Between Procedures
Name factors that can influence a patients hygiene practices
culture, personal preference, socioeconomic status
Between the non-rebreather mask and Venturi mask, which one offers the most oxygen and which one offers the most precise amount of oxygen
non-rebreather mask=most oxygen
venturi=most precise
A nurse is caring for a client who requires a low residue diet. What is the patient allowed to eat?
a. cooked barely
b.pureed broccoli
c. vanilla custard
d. lentil soup
c
Name the contradictions for using heat and cold therapy
heat- first 24 hr after injury, active bleeding, non inflammatory edema and certain skin disorders
cold-cold intolerence, vascular insufficiency, open wounds, or disorders aggravated by cold
Name some of the drug resistant micro-organisms
MRSA, VRSA, CDiff,
Name and briefly explain the two different scales we learned to measure a patients risk
Braden Scale- predicts pressure ulcer risk
Morse Scale- predicts fall risk
What are the manifestations of oxygen toxicity
nonproductive cough, substernal pain, nausea, vomiting, fatigue, dyspnea, restlessness, numbness
What is included in output measurement?
urine, blood, emesis, diarrhea, tube drainage, wound drainage, fistula drainage
What must a provider do in order to prescribe restraints
A charge nurse is reviewing with a newly hired nurse the difference in manifestations of a localized versus systemic infection. Which of the following are manifestations of a systemic infection? (select all that apply)
a.fever
b.malasie
c.edema
d. pain or tenderness
e. increased pulse and respirations
A,B,E
Name the steps that need to be taken when a client has a siezure
Do not restrain client, protect their head, place them on side, loosen clothing if possible, maintain airway
Describe how to take orthostatic vitals and the changes that would indicate the patient is positive for orthostatic hypotension
lying, sitting, standing
change of 20 on top and change of 10 on bottom
Name expected findings of poor nutrition
fat loss, dry scaly skin, brittle hair and nails, mental changes, weakness, flaccid muscles, change in bowel pattern
Name the three types of gaits associated with crutches
four point, three point and two point